Lifestyle & Health : Treating acid reflux

JB is a middle-aged woman of 58 years who suffers with rheumatoid arthritis and takes a non-steroidal anti-inflammatory drug (NSAID]-aspirin like drug) along with several other medications for her pain and discomfort.

Some time ago, she experienced a sore throat and hoarseness and found it difficult to maintain her singing voice for church. She visited her doctor and was diagnosed with acid reflux and placed on a proton pump inhibitor (like Nexium, Omeprazole, Pantecta, Omez, Lanzap, etc).

She has been taking these medications for some time now but did not discontinue her arthritis medications. In recent months, JB has also noticed that she feels like she is always swallowing a lump in her throat. She is also experiencing a dry cough. JB suspects that her acid reflux is worsening despite using medications but is fearful of even worse afflicting her. She has also tried stopping her NSAID pain killers but suffers bad pain when she does so.

She is tormented with pains and a burning sensation to both her feet when she stops taking her arthritis medications. JB asks Check Up for help with treating her acid reflux.

JB's situation is a difficult one to solve as the treatment for the arthritis can worsen the acid reflux (GERD). Ideally, she should visit both a rheumatologist (or rheumatology clinic) to try to sort out her arthritis using medications that will not worsen her GERD, and she should also see her ear, nose, and throat doctor or a gastroenterologist (or visit those specialty clinics) to obtain specialist treatment for the GERD.

Check Up will also make some suggestions as to how to treat GERD.

At the lower end of the oesophagus (gullet), where the food enters the stomach, is a muscular sphincter that functions as a one-way valve, preventing stomach acid from entering the oesophagus by a back flow from the stomach. The tissues of the oesophagus are much less resistant to the stomach acid that will burn them. When this one-way valve begins to leak (sometimes referred to as a Hiatus Hernia), acid flows back from the stomach to the oesophagus, giving rise to a possible multitude of symptoms in the chest region and throat. Risk factors for GERD include:

- Issues with swallowing as the oesophagus narrows due to acid damage and scarring

- Hiccups

- Nausea

- Weight loss

•Post-meal pain

- Chest pain, which worsens at rest

- Hoarseness

- Sore throat

- Cough

- Asthma

- Extra saliva in mouth

One effective way to treat GERD is to avoid foods and beverages that trigger the condition and eat smaller meal portions more frequently throughout the day. If obese, lose weight and don't wear tight clothing. Also, elevate the bed head at night-time with blocks. Healthy lifestyles is one key to improving GERD symptoms.

In many cases, lifestyle modifications, along with over-the-counter medications such as antacids (Dica, Maalox, Riopan, Relcer gel, etc) are all that is needed to settle GERD as they neutralize stomach acid. When antacids don't work, prescription drugs such as H2 receptor blockers like Zantac or proton pump inhibitors like Nexium, Pantecta, Omeprazole, or Lansoprazole can be regularly prescribed as these block the production of stomach acid.

Alternative treatment for GERD includes a low carbohydrate diet as well as several fruit-source anti-oxidants. These include:

- Lime or lemon juice is acidic and if consumed in significant amounts can worsen GERD, but they have an opposite response when lime or lemon juice (two teaspoonfuls) is consumed in a glass of water. Unexpectedly, limes and lemons, when consumed with water, have an alkaline effect on the stomach lining. Lemon or lime water drunk just before a meal will help the body maintain a higher and healthier PH. If needed, it can also be sweetened with honey before drinking.

- Pawpaw is another fruit that decreases indigestion and the heartburn experienced with GERD. It helps to break down the food ingested and decreases the amount of Gastric acid produced.

- Soursop leaf tea

- Aloe vera juice.

When lifestyle changes and medications don't work, surgery can be considered to tighten the leaking sphincter or leaking valve between the stomach and or oesophagus. This procedure is only considered as a last resort when all other treatments have failed.

JB is advised to set visits for review with specialist clinics to obtain a proper resolution to her unique situation.